A Cross Sectional Study to Determine Prevalence of Insulin Resistance among HIV Positive Subjects on Anti Retroviral Therapy.

Abstract

Introduction: The introduction of combination anti-retroviral therapy (c-ART) have declined the mortality and morbidity from HIV. However use of anti retroviral therapy have lead to metabolic disorders like impaired glucose tolerance and diabetes, as well as lipid disorders leading to an increase of cardiovascular disease. This study was aimed at to find out the prevalence of the insulin resistance and association of the insulin resistance with clinical and biological variables, including serum adipokines in HIV infected non-diabetic population undergoing combination ART therapy. Material and Methods: A cross-sectional research was done in a cohort of HIV-1-positive patients attending Anti Retroviral Treatment Center (ART) of a tertiary care Hospital from December 2017 to December 2018. HIV-infected cases above 18 years, undergoing stable cART for at least 6 months were included in this study. The patients were asked to complete a questionnaire during the medical visit for demographic parameters and for personal and family medical histories. Investigations such as fasting plasma insulin, and circulating adiponectin, leptin, resistin, tumor necrosis factor alpha (TNFalpha) and interleukin-6. (IL-6) levels were carried out. Results: A total of 64 patients (aged 16–68 year, median: 31 years) including 40 men (62.5%) and 12 women (37.5%) were included in the study. Forty four patients (68.75%) were diagnosed with IR based on QUICKI values lower than the cut-off point. The presence of the IR was not influenced by either the time of the HIV diagnosis or by the duration of cART. Treatment with protease inhibitor therapy, decreased adiponectin and increased serum triglycerides were associated with increased IR. Conclusion: We observed that the prevalence of the insulin resistance more in non-diabetic cases with HIV infection undergoing antiretroviral therapy and also there is an increased risk of developing diabetes mellitus and other cardiovascular diseases. Hence this study recommends that the management insulin resistance should be a integral component of HIVinfection therapeutic strategy.